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MedDRA® Version Updates
MedDRA® trademark is owned by IFPMA on behalf of ICH
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MedDRA was developed under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The activities of the MedDRA Maintenance and Support Services Organization (MSSO) are overseen by an ICH MedDRA Management Board, which is composed of the six ICH parties (EU, EFPIA, MHLW, JPMA, FDA, PhRMA), the Medicines and Healthcare products Regulatory Agency (MHRA) of the UK, the Health Canada, and the WHO (as Observer).
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Disclaimer and Copyright NoticeThis presentation is protected by copyright and may be used, reproduced, incorporated into other works, adapted, modified, translated or distributed under a public license provided that ICH's copyright in the presentation is acknowledged at all times. In case of any adaption, modification or translation of the presentation, reasonable steps must be taken to clearly label, demarcate or otherwise identify that changes were made to or based on the original presentation. Any impression that the adaption, modification or translation of the original presentation is endorsed or sponsored by the ICH must be avoided. The presentation is provided "as is" without warranty of any kind. In no event shall the ICH or the authors of the original presentation be liable for any claim, damages or other liability arising from the use of the presentation.The above-mentioned permissions do not apply to content supplied by third parties. Therefore, for documents where the copyright vests in a third party, permission for reproduction must be obtained from this copyright holder.
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ObjectivesTo provide an understanding of:
• Where to find information on practical approaches to MedDRA versioning
• Extent of versioning• Impact of MedDRA versioning in your
organization• Timing of updates• MSSO provided resources to assist with
version updates
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Background and Information on Approaches
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• MedDRA is a user responsive terminology
• Subscribers may submit change requests– 100 change requests maximum per month
• Twice yearly official updates– 1 March X.0 release (all levels)– 1 September X.1 release (LLT and PT levels
only)
MedDRA Maintenance
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MedDRA Growth TrendNumber of Implemented Changes per Release
0
1000
2000
3000
4000
5000
6000
7000
6.0 6.1 7.0 7.1 8.0 8.1 9.0 9.1 10.0 10.1 11.0 11.1 12.0 12.1 13.0 13.1 14.0 14.1 15.0 15.1
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Goals of Version Updates• Goals of versioning
– Implement current version of MedDRA– Stay current with regulatory authorities and
partners– Harmonize use of MedDRA to optimize
communication of data
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Version Update Approaches• MSSO “Best Practice” document
– “Recommendations for MedDRA Implementation and Versioning in Clinical Trials” (http://meddramsso.com/files_acrobat/clinicaltrialversioning.pdf)
– Six options involving either “freezing” a version or re-coding at various points
– MSSO recommends Options 5 or 6
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Extent of Version Updates
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Extent of Update• What does it mean to implement latest
version of MedDRA?– Since coding terms in MedDRA (LLTs) are
not deleted, an organization could simply apply latest version with no data changes
– What does your organization do?• Data coded to LLTs that become non-current• Data that have direct matches to new terms• Medically “better” terms available in new
version
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Extent of Update (cont)
• Many approaches to versioning by industry and regulators
• No real regulatory mandate• Issue is addressed in MedDRA Term
Selection: Points to Consider document (MTS:PTC)
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Versioning “Best Practice” (cont)• Implementation methods described in MTS:PTC
Method Description Resource Intensity Data Accuracy
1 Begin to use new version for coding new data; no recoding of existing data Least Least
2 Identify verbatim terms linked to non-current LLTs and recode existing data
3
Identify verbatim terms linked to non-current LLTs and recode existing data
andRecode verbatim terms to new LLTs that are direct or lexical
matches
4
Identify verbatim terms linked to non-current LLTs and recode existing data
andRecode verbatim terms to new LLTs that are direct or lexical
matchesand
Recode verbatim terms to new LLTs that are more accurate concepts
Most Most
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Impact of Version Updates
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Impacts of New Versions• Key point – LLTs/PTs are never deleted in
MedDRA
Type of Change ImpactLLT/PTs are moved Be aware of change, not
necessary to change codingLLTs change currency Probably need to re-code
LLT/PTs change primary SOC Be aware of change, not necessary to change codingUnderstand impact on summary reporting
LLT/PTs are added May cause re-coding
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Impacts of New Versions (cont)
Type of Change ImpactRevisions, additions to hierarchy
Be aware of change, not necessary to change codingUnderstand impact on summary reporting
Addition of new SMQs No impact on codingUseful information for data analysis and reporting
Changes to existing SMQs. PTs added or made inactive
No change to coding but be aware of impact on data analysis
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Impact of Version Updates on Data Analysis
• Version used in data retrieval and presentation should be documented
• Terms used for queries should be in same version as data being queried
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MedDRA Versioning -Effect of PT Demotion
MedDRA Version 13.1 Number of Events at PT Level
Malignant neoplasm progression (PT) 15
Neoplasm malignant 5
MedDRA Version 14.0 Number of Events at PT Level
Malignant neoplasm progression (no longer a PT)
0
Neoplasm malignant 20
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MedDRA Versioning (cont) -Effect of Primary SOC Change
MedDRA Version 13.1 Number of Events
SOC Injury, poisoning and procedural complicationsPT Retinal scar
20
MedDRA Version 14.0 Number of Events
SOC Injury, poisoning and procedural complications
0
SOC Eye disordersPT Retinal scar
20
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Timing of Version Updates
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Timing of Update (cont)From the MSSO “Best Practice” recommendations
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Timing of Update (cont)• Impact limited to data that are being
transmitted– Internal data (i.e., some clinical trial data) could
follow a different schedule
• EMA and MHLW will accept current version plus previous version for ICSRs and SUSARs
• FDA has no version requirement– Follows MSSO recommendation for versioning
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Issues with Timing• Currently, organizations may be
implementing on different dates1. On release date2. During implementation period3. At end of implementation period
March 1 May 6
Implementation Period
1 2 3
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Issues with Timing (cont)
• Differences in implementation date negatively impact communication of ICSRs
• EMA issued letter supporting original MSSO recommendation
• MSSO is working with regulatory authorities to coordinate implementation for all MedDRA users
• MSSO recommendation is to transition ontransition date– Not by transition date
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Resources for Version Updates
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Resources for Version Updates
• What’s New document• MSSO “What’s New” webinars – now free• Sequence files• MedDRA Version Reports• MedDRA Version Analysis Tool (MVAT)
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MedDRA Version Reports• Developed by MSSO to provide list of
changes between latest version and previous version
• Detailed record-by-record report• Included in the MedDRA terminology
download
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MedDRA Version Reports
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MVAT• MedDRA Version Analysis Tool• Three things that MVAT can help you
do:– Generate MedDRA Version Report between
any two versions of MedDRA (including non-consecutive ones)
– Search a term change– Identify changes specific MedDRA terms of
interest to the to user
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MVAT (cont)• Features
– Web-based– Free with subscription– Spreadsheet export and import
• Reports are informational only– Will not perform autoencoding tasks
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How to Access MVAT• https://mssotools.com/mvat/ or
– The MSSO web site under Subscriber Download
• MedDRA UserID and Password to login31
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MVAT Help• MVAT training videocast
– http://www.meddramsso.com/public_videos.asp – Videocast can also be downloaded
• MSSO Help Desk: [email protected]• MVAT FAQs:
http://www.meddramsso.com/public_faq_mvat.asp
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Summary• In this video cast, we:
– Practical approaches to MedDRA versioning – Learned about the timing and extent of
MedDRA version updates– Considered the impact of version updates
on coded data, including data analysis– Learned about resources available to assist
in version updates
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MSSO Contacts• Web site
• www.meddramsso.com
• Help Desk– Phone
• International AT&T Toll Free: 877.258.8280• Direct Dial (USA): +1 571.313.2574
– E-mail• [email protected]